title: Severity of diarrhea and malnutrition among under five-year-old children in rural Bangladesh.
abstract: Enteric pathogens are commonly associated with diarrhea among malnourished children. This study aimed to determine the association between the severity of diarrheal illnesses and malnutrition among under 5-year-old children. During 2010 and 2011, we studied 2,324 under 5-year-old diarrheal children with mild disease (MD) and moderate-to-severe disease (MSD) attending a hospital in Bangladesh. Children with MSD were more likely to be malnourished compared with children with MD (35% versus 24%, P < 0.001). In multivariate analysis, malnutrition (odds ratio [95% confidence interval] = 1.53 [1.22, 1.92]), age of the child (24-59 months; 1.67 [1.28, 2.19]), fever (1.65 [1.28, 2.12]), abdominal pain (1.87 [1.48, 2.37]), straining (5.93 [4.80, 7.33]), and infection with Shigella (3.26 [2.38, 4.46]) and Vibrio cholerae (2.21 [1.07, 4.58]) were shown to be significantly associated with MSD. Factors significantly associated with malnutrition were disease severity (1.56 [1.24, 1.95]), age (24-59 months; 1.75 [1.38, 2.22]), mother's schooling (1.54 [1.16, 2.04]), and monthly household income (1.71 [1.42, 2.07]). Childhood malnutrition was associated with dysentery and dehydrating diarrhea.
authors.affiliation: International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. farzanaf@icddrb.org
authors.forename: Farzana
authors.initials: F
authors.lastname: Ferdous
authors.forename: Sumon K
authors.initials: SK
authors.lastname: Das
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Ahmed
authors.forename: Fahmida D
authors.initials: FD
authors.lastname: Farzana
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Latham
authors.forename: Mohammod J
authors.initials: MJ
authors.lastname: Chisti
authors.forename: Abu I M S
authors.initials: AI
authors.lastname: Ud-Din
authors.forename: Ishrat J
authors.initials: IJ
authors.lastname: Azmi
authors.forename: Kaisar A
authors.initials: KA
authors.lastname: Talukder
authors.forename: Abu S G
authors.initials: AS
authors.lastname: Faruque
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011159:Population Surveillance; D012424:Rural Population; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires